Responsibility to Care: The Doctors’ Call to End War

1. Responsibility to Care:The Doctors’ Call to End War Mary-Wynne Ashford, MD, Ph.D Peace Through Health Conference McMaster University May 6, 2005

2. War is the deliberate use of suffering, injury, deprivation and death for political gain

3. Doctors’ Call to End War • Not a pacifist stance • Based on public health consequences of contemporary war • Scale of devastation and human suffering • Long term effects • Untenable use of political power

7. Rwanda

9. Vietnam

10. Hiroshima and Nagasaki

11. Hiroshima

12. Project: r2care.org Web based resource using expert papers: • Analysis of War using Medical Paradigm • Application of Medical Ethics and Values • Medical Action to Prevent War Toolkit for advocacy

13. Medical Analysis of War Epidemiology • Incidence • Prevalence • Morbidity • Mortality

14. Etiology -Immediate causes -Intermediate causes -Root causes or contributing factors

15. Diagnosis • History • Weapons • Signs and symptoms

16. Treatment • Responding to suffering and injuries • Addressing social determinants • Addressing global root causes

17. Prognosis based on weaponry • Nuclear • Biological • Chemical • Conventional • Destruction of civil infrastructure Prognosis based on political context

18. Prevention • Primary • Secondary • Tertiary

19. Rehabilitation • Individual • Social • Global

20. Case Studies A. Specific war zones - report by physicians using medical paradigm B. Successful campaigns -International Campaign to Ban Landmines C. Recommendations

21. Medical Ethics and Values Above all do no harm: • Least damaging intervention first • Benefit must be greater than harm • Refuse to support practices that violate basic human rights

22. Reasonable likelihood of success • Involve patient, family, community and society • Early action • Follow up and rehabilitation planned at outset

23. Responsibility to CareValues • Each life is of equal value • Morally wrong to cause suffering and death • Morally wrong to starve people • Morally wrong to destroy the environment for political gain • Political conflicts have political solutions

24. Responsibility to CareValues • Not universally supported • Not limited to physicians or even to health care workers • Values rather than code of ethics • May or may not be based in religious faith

25. Doctor’s Role • To prevent or ease suffering and to prevent death • Duty to treat all who are suffering: -combatants or non-combatants -enemy or ally

26. Responsibility to Care May reflect personal values such as: • Inner sense of duty to serve • Source of meaning of life • Extending circles of compassion to include humanity and the earth • Sense of being called

27. Medical Action to Prevent War Activist Kit • Writing papers for web site • Advocacy and information • Skills building: speaking and media • Organizational help • Projects to join • Links to organizations

28. “… on this earth there are pestilences and there are victims, and it’s up to us in so far as possible, not to join forces with the pestilences.”Albert Camus, “The Plague”.

29. Responsibility to Care • Mary-Wynne Ashford MD, Ph.D. • mashford@uvic.ca • 250 479 9189